Consultant – Orthopaedic Surgeon
Speciality interests include:
Lower extremity: trauma, sports surgery, knee, patella dislocation, tendon problems, foot and ankle surgery, and the management of degenerative joint disease in younger patients.
Visiting on Sep 21-22, 2019Request an Appointment
The rotator cuff is a group of muscles and tendons that form a cuff over the shoulder joint. These muscles and tendons hold the arm in its joint and help the shoulder joint to move. The tendons, which help in raising and lowering the arm, can be torn from overuse or injury. Tears of the rotator cuff are very common because of the active use of the joint and the natural wear and tear over time. Surgery becomes an option in cases of tears when non-surgical methods do not improve outcomes or alleviate pain.
Front (left) and overhead (right) views of the tendons that form the rotator cuff. The blue arrows indicate a full-thickness tear in the supraspinatus tendon, the most common location for rotator cuff tears.
Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of the humerus (upper arm bone). A partial tear, however, may need only a trimming or smoothing procedure called a debridement. A complete tear is repaired by stitching the tendon back to its original site. The type of repair performed depends on several factors, including the surgeon’s experience and familiarity with a particular procedure, the size of the tear, the patient’s anatomy, and the quality of the tendon tissue and bone. Recurrent tear after rotator cuff repair, however, is common. Tear recurrence can be related to various factors such as (1) inadequate strength of the initial repair construct, (2) biological failure to heal despite strong initial fixation and (3) inappropriate postoperative rehabilitation causing structural failure of the repair
At Emirates Integra, we explore the best solutions that are evidence-based in research to provide the most optimal outcomes for patients. For rotator cuff repairs, we have found technologies that support long-lasting effective repair. Newer knotless devices are available to engage suturing and provide strong friction hold. Surgical buttons, one such knotless device, disperse pressure across a larger surface area to help prevent the suture from tearing out through the tissue.
This type of tear is a very common failure mechanism and can be the source of recurrent tear after rotator cuff repair. Studies have shown that the addition of the button to the rotator cuff repair device stabilizes the tissue to help prevent this form of failure. Additionally, it creates increased contact surface area, which should allow for better and improved tissue healing while decreasing the rate of non-healing and re-tears.